Background to this inspection
Updated
17 February 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was completed by 1 inspector.
Service and service type
The Berkeley is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Berkeley is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 3 people who used the service and 2 relatives about their experience of the care provided. We spoke with 5 members of staff including the manager, compliance managers and care workers.
We reviewed a range of records. This included 3 people’s care records and multiple medication records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
Updated
17 February 2023
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
The Berkeley is a residential care home providing accommodation and personal care for up to 10 people with a diagnosis of learning disabilities, autistic spectrum disorder, mental health needs or sensory impairments. At the time of the inspection 7 people were living in the home.
People’s experience of using this service and what we found
Right Support:
Risks to people had not always been assessed and strategies to reduce the known risks had not always been recorded. The provider implemented the missing risk assessments and completed mitigating strategies immediately after the inspection.
Medicine management required further improvement. Medicine records were not always consistently recorded. The provider was aware, and actions were being put into place.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice.
Right Care:
People were supported by staff who knew them well and who had been safely recruited. However, not all staff had the relevant training to ensure they had the knowledge of people’s health needs. The provider allocated new training to all staff immediately after inspection feedback.
People, relatives and staff knew how to complain. The provider had processes in place to support whistleblowing, raising complaints and completing the duty of candour.
People, relatives and staff were given the opportunity to feedback on the service. The provider sent out annual surveys and feedback was sought during regular reviews.
Right Culture:
Systems and processes to ensure good management oversight and to make improvements required improving. Not all processes were effective in identifying concerns and improvements needed. The provider implemented new systems and processes after the inspection, these will need to reviewed at the next inspection to establish if they are effective and embedded into practice.
Staff felt supported in their roles and received regular supervisions and meetings to raise any concerns, give suggestions or feedback on the service delivered.
People and relatives were positive about the attitudes and behaviour of staff and the culture of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (Published 06 December 2018)
Why we inspected
This inspection was prompted by a review of the information we held about this service. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Berkeley on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified a breach in relation to management oversight and governance at this inspection.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.